内科胸腔镜检查对结核性胸膜炎引起胸腔积液的诊断作用分析  

Analysis of the Diagnostic Effect of Internal Thoracoscopy on Pleural Effusion Caused by Tuberculous Pleurisy

作　　者：黎国喜 刘智 郭清[1] LI Guo-xi;LIU Zhi;GUO Qing(Department of Respiratory Intensive Care,Gaozhou People's Hospital,Gaozhou,Guangdong Province,525200 China)

机构地区：[1]高州市人民医院呼吸重症学科,广东高州525200

出　　处：《中外医疗》2020年第24期55-57,共3页China & Foreign Medical Treatment

摘　　要：目的探讨内科胸腔镜检查应用于结核性胸膜炎引发胸腔积液中的诊断价值。方法方便抽取2018年5月—2019年11月该院收治的62例不明原因胸腔积液患者作为研究对象,给予所有患者内科胸腔镜检查并观察其镜下表现特征。结果研究收入的62例不明原因胸腔积液患者经内科胸腔镜病理组织活检确诊患者60例,诊断符合率96.77%,结核性胸腔积液50例、非特异性炎症1例;恶性胸腔积液10例,胸腔镜表现可归结为4类:胸膜充血水肿、粟粒样结节、纤维素样粘连带和包裹性积液;恶性胸腔积液患者10例CEA胸水、CEA血高于结核性胸腔积液50例患者(50.00%、40.00%>4.00%、8.00%),结核性胸腔积液患者ADA胸水高于恶性胸腔积液患者(64.00%>30.00%),各数据组间均差异有统计学意义(χ^2=53.678、28.070、23.203,P<0.05)。结论结核性胸腔积液的诊断难度相对于其他类型胸腔积液更高,内科胸腔镜检查可通过较为典型的胸腔镜下表现提高其诊断准确率,方法值得借鉴。Objective To explore the diagnostic value of internal thoracoscopy in tuberculous pleurisy caused by pleural effusion.Methods A total of 62 patients with unexplained pleural effusion admitted to the hospital from May 2018 to November 2019 were convenient selected as the research objects.All patients were given medical thoracoscopy and their microscopic performance characteristics were observed.Results The 62 patients with unexplained pleural effusion received from the study were diagnosed by medical thoracoscopic pathological tissue biopsy in 60 patients,the diagnosis coincidence rate was 96.77%,50 cases of tuberculous pleural effusion,1 case of non-specific inflammation;10 cases of malignant pleural effusion;the performance of thoracoscopy can be summarized into four categories:pleural congestion and edema,miliary nodules,fibrinoid adhesions and encapsulated effusion;10 cases of malignant pleural effusion patients with CEA pleural effusion,CEA blood higher than tuberculous pleural effusion 50 cases(50.00%,40.00%>4.00%,8.00%),ADA pleural fluid in patients with tuberculous pleural effusion was higher than that in patients with malignant pleural effusion(64.00%>30.00%),and there were statistical differences significant between the data groups(χ~2=53.678,28.070,23.203,P<0.05).Conclusion The diagnosis of tuberculous pleural effusion is more difficult than other types of pleural effusion.Medical thoracoscopy can improve its diagnostic accuracy through more typical thoracoscopic performance.The method is worth learning.

关 键 词：内科胸腔镜 结核性胸膜炎 胸腔积液 胸腔镜表现 诊断价值 

分 类 号：R521.7[医药卫生—内科学]